Forbes columnist Steven Salzberg and author-investigator Joe Nickell will each be awarded the 2012 Robert P. Balles Prize in Critical Thinking, to be presented by the Committee for Skeptical Inquiry at the CFI Summit in October.

The Columbia University ‘Miracle’ Study: Flawed and Fraud

The much-hyped Columbia University prayer study was flawed and suspicious from the start but now has been fatally tainted with fraud. The first-named author doesn't respond to inquiries. The “lead” author said he didn't learn of the study until months after it was completed. And now the mysterious third author, indicted by a federal grand jury, has pleaded guilty to conspiracy to commit fraud. All his previous studies must now be questioned.

On September 11, 2001, the United States of America was rocked by perhaps the most horrific event in its history. In the horrible and uncertain days following the destruction of the World Trade Center (and other attacks) by Islamic zealots many Americans turned to prayer. Millions prayed in their homes and churches as their senators and congressmen prayed on the steps of the Capitol building and their president prayed in the White House. Bumper stickers, signs, and banners flooded the nation proclaiming, “God Bless America” and “Pray for America.” Millions of faithful Americans prayed for a miracle or perhaps a sign from God. Three weeks later such a miracle occurred. The timing could not have been better.

On October 2, 2001, the New York Times reported that researchers at prestigious Columbia University Medical Center in New York had discovered something quite extraordinary (1). Using virtually foolproof scientific methods the researchers had demonstrated that infertile women who were prayed for by Christian prayer groups became pregnant twice as often as those who did not have people praying for them. The study was published in the Journal of Reproductive Medicine (2). Even the researchers were shocked. The study’s results could only be described as miraculous. This was welcome and wonderful news for a shaken nation.

Columbia University issued a news release claiming that the remarkable study had several safeguards in place to eliminate bias and that the study itself was carefully designed to eliminate bias (3). This was no hoax. Media attention immediately focused on the miraculous study, and articles touting its spectacular results quickly appeared in newspapers around the world. Rogerio Lobo, chairman of the Department of Obstetrics and Gynecology at Columbia and the study’s lead author, told Reuters Health that, “Essentially, there was a doubling of the pregnancy rate in the group that was prayed for” (4). Dr. Timothy Johnson, ABC News medical editor and Good Morning America commentator, stated, “A new study on the power of prayer over pregnancy reports surprising results; but many physicians remain skeptical” (5).

The facts I will relate here about the Columbia University “miracle” study confirm that those physicians who doubted the study’s astounding results had extremely good reasons to be skeptical. It remains to be seen whether ABC’s Dr. Johnson, a medical doctor who also serves as a minister at the evangelical Community Covenant Church in West Peabody, Massachusetts, will report or ignore the following shocking information that has since been revealed about the alleged study and its authors.

The “Miracle” Study

In vitro fertilization (IVF) is the most advanced form of infertility treatment currently available and represents the last hope for women with severe infertility. Therefore, any technique that could increase the efficacy of IVF by even a few percent would be a medical breakthrough. Yet the Columbia University study claimed to have demonstrated, in a carefully designed randomized controlled trial, that distant prayer by anonymous prayer groups increased the success rate of IVF by an astounding 100 percent (2). The Cha/Wirth/Lobo study involved 219 infertility patients in Seoul, South Korea, who required in vitro fertilization. Twenty patients were excluded due to incomplete data, leaving 199 study subjects. After randomization, 100 patients were assigned to the study group to receive IVF plus prayer from Christian prayer groups in the United States, Canada, and Australia. The control group of ninety-nine patients received IVF but did not receive any prayers from these prayer groups. In vitro fertilization was performed in the usual fashion in both groups. The 100 patients in the study group were not informed that the groups were praying for them. Furthermore, none of the patients were even informed that they were being used as study subjects. The prayer groups, which were thousands of miles away from the study subjects, prayed over photographs that had been faxed to them from Korea. Remarkably, the pregnancy rate in the prayed-for group (50 percent) was almost twice as high as the pregnancy rate in the nonprayed-for group (26 percent, p= .0013). The highly significant results seem to indicate that something spectacular had occurred.

However, even a cursory review of the report reveals many potential flaws. For one thing, the study protocol was convoluted and confusing, involving at least three levels of overlapping and intertwining prayer groups. Tiers 1 and 2 each consisted of four blocks of prayer participants. Prayer participants in tier 1, block A, received a single sheet of paper with five IVF patient’s pictures (a treatment “unit”) and prayed in a directed manner with a specific intent to “increase the pregnancy rate” for these patients about whom they apparently had no information whatsoever. Prayer participants in tier 2, block A, apparently performed two different types of prayer. First, they prayed for their fellow prayer participants in tier 1, block A, with the intent to “increase the efficacy of prayer intervention.” In other words, they were apparently praying to increase the effectiveness of their colleagues’ prayers, whatever those prayers might be. Next they prayed in a nondirected manner for the study patients with the “intent that God’s will or desire be fulfilled in the life of the patient.” Similar prayers apparently took place in all of the other blocks. Finally, in addition to all of the above groups, tiers, blocks, and units, a separate group of three individuals prayed in a general nonspecific manner with the intent that “God’s will or desire be fulfilled for the prayer participants in tiers 1 and 2.” In other words, these final three prayer participants were praying to increase the efficacy of the second tier of prayer participants who were in turn praying to increase the efficacy of the first tier of prayer participants who were in turn praying for increased pregnancy rates in the study patients.

As can be seen from this brief description, the study protocol was so convoluted and confusing that it cannot be taken seriously. Of course, a simple protocol could have been used to determine if prayer was efficacious in increasing the success rate of IVF. One might simply instruct a few believers to pray for successful IVF in the study group while no one prayed for patients in the control group. With distant prayer the patients would not know if they were being prayed for, or not, so there would be no intention-to-heal or placebo bias. Contrast this with the study design described above and draw your own conclusions. This article is too brief to describe all of the study’s flaws but readers who want more information are referred to two critiques I have published in The Scientific Review of Alternative Medicine (6,7).

Briefly, here are a few problems I pointed out. Choosing a complex study design rather than a simple one requires explanation, however the authors give no reason for selecting a bewildering study design. Including prayers asking that “God’s will or desire be fulfilled” introduced a vague and obfuscating concept that cannot be measured as an endpoint: no one knows what God’s will is, hence any outcome could be viewed as a success. The authors made no attempt to discover how much prayer was being conducted outside the study protocol, perhaps to other gods, since only one-third of Koreans are Christians. Occam’s razor (the principle that a simple explanation rather than a convoluted one is more often correct) demands that highly unlikely results be viewed with suspicion. Is it more likely that this study is flawed or fraudulent or that the authors have demonstrated the existence of a supernatural phenomena and thus have made perhaps the most important discovery in history?

The Columbia University Connection

The study’s three authors were Kwang Cha, Rogerio Lobo, and Daniel Wirth. Kwang Yul Cha, M.D., was the director of the Cha Columbia Infertility Medical Center at the time of the “miracle” study but apparently severed his relationship with Columbia soon after the study was published. A page on Columbia’s Web site, which has since been removed, described Cha as an “internationally renowned clinician and researcher.” Cha is a graduate of the Yonsei Medical School in Seoul, South Korea. Professor Rogerio A. Lobo, M.D., recently stepped down as chairman of the department of obstetrics and gynecology at Columbia University. When the study results were announced, Dr. Lobo told the New York Times that the idea for the study came from Dr. Cha; however, the Columbia news release claimed that Dr. Lobo led the study. For two years both Dr. Cha and Dr. Lobo have refused to return my phone calls and e-mails asking questions about the study. The study’s third author, Daniel Wirth, who will be described below, has no known connection with Columbia University other than his participation in the study.

In December 2001, the Department of Health and Human Services (DHHS), after being alerted by media coverage, launched an investigation into the lack of informed consent in the Columbia study.

Columbia University subsequently acknowledged noncompliance with its Multiple Project Assurance (MPA) and its own policies and procedures (8). Specifically, Dr. Lobo never presented the above research to the Institutional Review Board (IRB) of Columbia-Presbyterian Medical Center (CCPM). In response to the DHHS investigation Columbia University agreed to have its IRB perform an educational in-service for Lobo’s department.

In addition, in December 2001, Columbia University Vice President Thomas Q. Morris, a physician, informed the DHHS that Dr. Lobo first learned of the study from Dr. Cha six to twelve months after the study was completed and that Lobo primarily provided editorial review and assistance with publication (8). This seems inconsistent with Lobo being listed as one of the study’s authors. This also conflicts with the fact that Lobo was identified by both The New York Times and ABC News as the report’s lead author. Lobo was also identified as the report’s lead author in a news release posted for two years on the Columbia University Web site. Interestingly, the press release has recently been removed from the Columbia site. If the report’s lead author did not conduct the international prayer study, who did?

The Mysterious Daniel Wirth

The remaining author is a mysterious individual known as Daniel P. Wirth. In October 2002, one year after the Cha/Wirth/Lobo study was published, Mr. Wirth, along with his former research associate Joseph Horvath, also known as Joseph Hessler, was indicted by a federal grand jury (9). Both men were charged with bilking the troubled cable television provider Adelphia Communications Corporation out of $2.1 million by infiltrating the company, then having it pay for unauthorized consulting work. Police investigators discovered that Wirth is also known as John Wayne Truelove. FBI investigators revealed that Wirth first used the name of Truelove, a New York child who died at age five in 1959, to obtain a passport in the mid-1980s. Wirth and his accomplice were charged with thirteen counts of mail fraud, twelve counts of interstate transportation of stolen money, making false statements on loan applications, and five other counts of fraud. A federal grand jury concluded that the relationship between Wirth and Horvath extended back more than twenty years and involved more than $3.4 million in income and property obtained by using false identities. In addition to the Adelphia scheme, Wirth apparently found a way to defraud the federal government by collecting Social Security benefits totaling approximately $103,178 from 1994 to 2003 in the name of Julius Wirth. This man, possibly Daniel Wirth’s father, died in 1994 but his benefits continued to be paid after his death via electronic funds transferred to the Republic National Bank.

Incredibly, at the time of the indictment, Horvath, Wirth’s partner, was already in jail, charged with arson for burning down his Pennsylvania house to collect insurance money (10). The FBI investigation revealed that Horvath had previously gone to prison in a 1990 embezzlement and false identity case in California. Interestingly, the investigation also revealed that he had also once been arrested for posing as a doctor in California. It appears that the “doctor” who performed biopsies on human research subjects in Wirth’s famous healing studies may have actually been Horvath impersonating a doctor. Horvath was a co-author on another of Wirth’s studies in which salamander limbs were amputated and found to grow back more quickly when “healers” waved their hands over the wounds.

Both Wirth and Horvath initially pled not guilty to the felony charges, and over the next eighteen months their trial was delayed six times. However, on May 18, 2004, just as the criminal trial of the United States v. Wirth & Horvath was finally about to begin, both men pled guilty to conspiracy to commit mail fraud and conspiracy to commit bank fraud (11). Each man faced a maximum of five years in federal prison and agreed to forfeit assets of more than $1 million obtained through fraudulent schemes. Horvath, however, was found dead in his jail cell on July 13, 2004, an apparent suicide.

Daniel Wirth’s Prior Research

Wirth, identified as Doctor Daniel Wirth on several of his publications, has no medical degree. He holds a master’s degree in parapsychology and a law degree. Wirth has a long history of publishing studies on mysterious supernatural or paranormal phenomena, mainly dealing with alternative and spiritual healing. Most of these studies originated from an entity called “Healing Sciences Research International,” an organization that Mr. Wirth supposedly headed. This entity, which sounds like a medical center or impressive research facility, could only be contacted through a post office box in Orinda, California. Between 1992 and 1997 approximately eighteen research papers authored by D.P. Wirth were published, mostly in obscure paranormal journals (12-29).

Wirth has stated that his experiments “represent a seminal research effort within the field of complementary healing,” and many faith healing advocates fully agree with his statement. Due to the apparently meticulous design and conduct of Wirth’s randomized, double-blind controlled studies he has become the virtual poster boy of alternative healing methods, particularly Noncontact Therapeutic Touch (NCTT). In NCTT the “healer” does not actually touch the patient but supposedly alters undetectable “human energy fields” surrounding the patient. According to Wirth, NCTT apparently achieves its healing effect by an interaction of “energy fields” between the practitioner and the subject. The method requires the healer to 1) “center” his/herself both physically and psychologically, 2) “attune” to the “energy field” of the subject by “scanning” with the hands two to six inches from the body in order to detect imbalances within or blocks within the energy field, and 3) consciously redirect and “rebalance” the energy in those areas of blockage (24). The existence of these imagined human energy fields has never been proven. Even if such fields did exist, it is not clear how a healer could possibly detect or modify them. In fact, in a recent study twenty-one experienced NCTT practitioners were unable to detect any “human energy fields” under blinded conditions. The study concluded that failure to substantiate TT’s most fundamental claim is unrefuted evidence that the claims of NCTT are completely groundless (30).

In addition to his extensive work on NCTT, Wirth has previously conducted several studies involving Christian faith healing. For example, he evaluated and reported on forty-eight patients treated by Greg Schelkun, a spiritual healer trained in the Philippines in the “Espiritista System” of faith healing (17). This system includes “psychic surgery,” laying on of hands, and distant prayer healing. It has a Christian foundation in which the practitioner supposedly cultivates divine healing by entering a trace-like state and opening themselves to the healing power of the Holy Spirit. Schelkun asserts that he acts only as a channel for the “universal energies” of God and that any “miraculous cures” that occur are due solely to the Grace of God. Wirth evaluated patients treated by Schelkun for conditions ranging from ovarian cysts to AIDS and even cancer. Wirth found that 90 percent of patients believed that their condition was improved by the treatment.

In October 2001 narcotics officers raided the Santa Monica, California, office of Dr. William Eidelman, co-author of many of Daniel Wirth’s papers. Eidelman is a believer in paranormal healing and an outspoken proponent of the medical use of marijuana. Officers presented a search warrant charging that Eidelman provided undercover narcotic agents with medical marijuana recommendations without valid medical grounds. On May 28, 2002, Eidelman’s license to practice medicine was suspended.

Journal of Reproductive Medicine

Perhaps the most fascinating aspect of this entire sordid saga can be summed up in one question: How did a bizarre study claiming extraordinarily unlikely and apparently supernatural results end up in a peer-reviewed medical journal? We may never know. For two years the editors of the Journal of Reproductive Medicine (JRM) refused to answer my calls or respond to letters about this study. The fact that study co-author Lobo serves on the Editorial Advisory Board of the JRM may or may not be relevant. It is known that Columbia University Vice President Thomas Q. Morris informed DHHS investigators that Dr. Lobo first learned of the study from Dr. Cha six to twelve months after the study was completed and that Dr. Lobo primarily provided editorial review and assistance with publication (8).

On May 30, 2004, the London Observer made many of these events public for the first time in an article titled “Exposed: Conman’s Role in Prayer-power IVF 'Miracle'"(31). The Observer article noted that the study was still posted on the JRM Web site and that phone calls from the Observer to the JRM were not returned. Three days after the scandal had been made public and linked to the journal, perhaps in response to an avalanche of inquiries, JRM co-editor-in-chief Dr. Lawrence Devoe finally stated that the Journal of Reproductive Medicine would remove the flawed Columbia study from its Web site and publish an editorial clarifying their author requirements. Both the Observer article and a June 7, 2004, article in The New York Sun stated that the authors did not respond to their requests for comment.

It must be emphasized that, in the entire history of modern science, no claim of any type of supernatural phenomena has ever been replicated under strictly controlled conditions. The importance of this fact cannot be overstated. One would think that all medical journal editors would be keenly aware of this fact and therefore be highly skeptical of paranormal or supernatural claims. One must therefore wonder if the Columbia researchers and the JRM editors were blinded by religious beliefs. Everything else being equal, if the claimed supernatural intervention had been Ms. Cleo manipulating Tarot cards rather than Christians praying, would the reviewers and editors have taken this study seriously? In any case, the damage has been done. The fact that a “miracle cure” study was deemed to be suitable for publication in a scientific journal automatically enhanced the study’s credibility. Not surprisingly, the news media quickly disseminated the “miraculous” results.

Damage Control

Clearly, JRM's belated decision to remove the Columbia study from its Web site will not correct the errors it made in publishing an absurd article and then persistently ignoring warnings about the mistake in doing so. Serious damage has been done. The editors were informed of several of the study’s flaws within weeks of its publication and yet allowed the entire study to remain on their Web site for two years. During that time the public was never given any reason to doubt the study’s validity or its miraculous claims. As a result of JRM's inaction the Cha/Wirth/Lobo study has been cited in many other “healing” publications and on other Web sites as strong scientific evidence for the validity of faith healing. A Google search performed on June 4, 2004, for the terms, “Wirth, Columbia, prayer” found 686 sites; many of these links led to articles touting the miraculous results of the Cha/Wirth/Lobo study.

Worse yet, the Columbia study is now being cited by faith healers as a shining example of “healing” research of the highest scientific quality. For example, I recently wrote a letter to the editor of Southern California Physician critical of its article “Prescription for Prayer” and the appalling claim by noted faith healer Dr. Larry Dossey that some 1,600 studies have revealed “something positive” about intercessory prayer. I commented that if there were, in fact, something positive it certainly wouldn't take 1,600 studies to find it! Dr. Dossey’s published response to my letter included the following convincing argument, “Controlled clinical trials and the peer-review process continue to serve us well. The most recent example of this process in action in the area of intercessory prayer is from Columbia Medical School-a positive, controlled clinical trial published in the respected, peer-reviewed Journal of Reproductive Medicine” (32). Yes, Dossey had used the hopelessly flawed Columbia “miracle” study to demonstrate the scientific validity of faith healing.

In the February 2004 edition of her nationally distributed newsletter, faith healing advocate Dr. Susan Lark cites the Cha/Wirth/Lobo study as strong evidence for the power of prayer (33). She notes that critics of faith healing have argued that most prayer studies have not been credible due to weak methodologies. However, she points out that “those researchers who believe in prayer are answering this critique quickly-and effectively. The fact is, the medical journals are rapidly filling with studies that are proving the power of prayer.” She then presents the proof by describing the Columbia “miracle” study.

In a published critique of phony healing methods, noted physician and chairman of the Dutch Union Against Quackery Dr. Cees Renckens has this to say about the Cha/Wirth/Lobo study: “Very recently a seemingly impeccable paper proving absurd claims was published in a serious and (hitherto?) respected journal in the field of reproductive medicine” (34). Dr. Renckens also states, “Fraud is difficult to extract from an apparently impeccable paper, but everyone is invited to draw one’s owns conclusions about the trustworthiness of the authors. We do not believe anything of the story and are very much opposed to publishing this kind of absurdity in serious journals.”

For both Columbia University and the JRM, the only honorable solution to this scandal is to fully and publicly disclose their mistakes and apologize for the attempted cover-up. Columbia erroneously submitted a profoundly flawed and absurd article and JRM erroneously published it. Simply claiming that they were duped by Wirth and attempting to blame him for their own mistakes would be unethical-and almost certainly false. It would also be a setback for science.

Conclusion

In summary, one of the authors of the Columbia Cha/Wirth/Lobo study has left the University and refuses to comment, another now claims he did not even know about the study until six months to a year after its completion and also refuses to comment. The remaining author is on his way to federal prison for fraud and conspiracy. Fraud is the operative word here. In reality, the Columbia University prayer study was based on a bewildering study design and included many sources of error. But worse than flaws, in light of all of the shocking information presented above, one must consider the sad possibility that the Columbia prayer study may never have been conducted at all.

Finally, Daniel Wirth’s history of criminal fraudulent activity casts a dark shadow over many of the supposedly seminal publications in the field of alternative and faith healing. In light of these facts, all of his frequently-cited publications must now be viewed with suspicion. While faith healers have performed rituals and cast out demons for millennia, they are now attempting to validate their claims with scientific methods and publish their results in peer-reviewed medical journals. It is one thing to tell an audience at a tent revival that prayers yield miracle cures but quite another thing to make the same claim in a scientific journal. By doing so, faith healers cross the line into the domain of science, a domain where superstitious and supernatural claims are not taken seriously.

Lessons from the 'Miracle' Study Scandal

The real scandal here lies not in Wirth’s actions but in those of Columbia University and the Journal of Reproductive Medicine. The scientific method is designed to detect and correct errors and misconduct. In this case the system failed in many places. In fact, if Wirth had not been arrested, the Cha/Wirth/Lobo study might have never been retracted.

Faith healing advocates like Drs. Dossey and Lark will no doubt try to put a positive spin on this scandal by claiming that it has successfully weeded out a few bad apples from an otherwise pristine bunch. Nothing could be further from the truth.

It is often claimed that faith healing may not work but at least does no harm. In fact, reliance on faith healing can cause serious harm and even death (35).

In the entire history of modern science, no claim of any type of supernatural phenomena has ever been replicated under strictly controlled conditions. All scientists and editors of scientific and medical journals should be fully aware of this obvious fact.

The “faith” in faith healing refers to an irrational belief, unsupported by evidence, that mysterious supernatural powers can eradicate disease. Science deals with evidence, not faith.

Publication of absurd studies and pseudoscience in medical and scientific journals does serious damage to the public’s perception of medical science and science in general.

Eisner, R. Prayer may influence in vitro fertilization success. Columbia News. This document remained on the Public Affairs News page of Columbia University Internet site for more than two years after the publication of the Cha/Wirth/Lobo study (www.columbia.edu/cu/news).

Bruce Flamm

Bruce L. Flamm is a clinical professor of obstetrics and gynecology at the University of California, Irvine. Dr. Flamm is the author of several medical books, book chapters, and research articles. In addition to his work in the medical field he is an expert in the history of calculating devices and has co-authored a book on the subject.

Content copyright CSI or the respective copyright holders. Do not redistribute without obtaining permission. Thanks to the ESO for the image of the Helix Nebula, also NASA, ESA and the Hubble Heritage Team for the image of NGC 3808B (ARP 87).